Suprapubic Catheter: How Tube Placement Works

If you require a suprapubic catheter, you will need to have a surgical procedure in order to facilitate the placement of the suprapubic tube (SPT). A suprapubic catheter, which is also known as a Foley catheter or a suprapubic Foley catheter enables those who need help in passing urine to do so. The need for this device arises when one is unable to pass urine normally.

Catheter Basics

The SPT, which is a flexible rubber tube, is implanted into the lower abdomen and into the bladder. In order to secure the catheter and ensure it will remain in place, a small balloon, which is attached to the device and filled with sterile water, is placed inside the bladder.

The suprapubic catheter is joined to a drainage bag, which is secured to one’s leg and worn under clothing when someone is active. At night, when sleeping, a larger bag is used along the bedside. These bags are always stationed at a level that is lower than the catheter in order to utilize gravity to encourage the drainage of urine from the bladder.

Typical Surgical Procedure

The procedure for suprapubic catheter placement is usually performed under local or general anesthetic in an operating room. Typically suprapubic catheter surgery
takes from one-half-hour to one-hour. In order to place the SPT into the bladder as small incision is made right above the public bone. Once the suprapubic tube is in place, the anchoring balloon is blown up. The surgeon will often suture from the outside of the body to the internal tube in order to make sure the tube stays stable and the patient is not disturbed by any movement of the device. Once your suprapubic catheter surgery is finished, the addition of the drainage tube and bag may be done as an outpatient procedure.

Home Care

After the operation, a bandage will be placed over the suture and incision. This bandage may be removed 24 to 48 hours after the operation. Prior to removing the bandage, the area will need to remain dry. Change the dressing whenever it gets wet and as often as is required. It is normal to blood in your urine or to have urine and blood leaking in the area of the tube during the initial two to three days.

After the bandage has been removed, proper care of the incision will help to protect the area from infection. Supplies required include:

Your dressing should be changed one each day. At the same time, you should perform proper skin care procedures, which includes inspecting and cleaning the area.

The Procedure

• Wash your hands in warm soapy water and dry them.
• Remove the drainage tubing and plug the catheter.
• Remove the dressing gently and discarding it in the trash.
• Carefully inspect the skin and incision. Normally there will be some redness in and clear or yellow liquid draining from the area. However, blisters, a large red area, excessive drainage, or a foul odor needs to be reported to your physician as soon as possible.
• Take the washcloth, wet it with warm water, and apply some liquid soap to it.
• Using care, wash around the skin and catheter, eliminating any drainage.
• Rinse the area and pat dry with the clean towel. Do not rub the area.
• Take the clean scissors and make a cut in the center of the 4×4 gauze pad. Place the pad around the suprapubic catheter, making sure it is properly positioned to allow for the insertion for the drainage tubing. Secure the gauze with tape.
• Replace the drainage tube, allowing for some slack to make sure that it won’t be pulled out. After making sure that the tubing is not kinked, secure it to the skin with some tape.
• After you are finished, wash you hands in warm, soapy water and dry.

Care of the Drainage Bag

There are various procedures and techniques related to the proper care of your drainage bag. Here are some of the things that you can and/or should do in relationship to your suprapubic catheter bag.

• If you need or would like to, you may shorten the drainage tube connected to the leg bag. Simply cut the tubing to the length you desire. When cutting, leave as much of the smooth section of the tubing as you can.
• The soft side of the drainage bag should be against your skin.
• Always make sure that the outlet at the bottom of the bag is closed. Make sure the closure snap is securely in place.
• If your leg straps connected to the bag are too long, you may shorten them.
• The straps, which attach the bag to your leg, should not be too tight, as this can cut off circulation.
• Unravel and smooth any kinks in the tubing, as kinking will prohibit drainage.
• Do not let the bag fill totally before emptying. Empty it when it is one-half to two-thirds full. Daytime bags are usually emptied about every 2 hours and night bags every 8.
• Bags may be emptied into the toilet, a large basin, or a urinal.
• To empty, aim the tube and direct the flow into the container and turn the clamp downwards to facilitate flow.
• Once the bag is emptied, flip the clamp upwards, making sure that it snaps shut.
• When cleaning the bag, after detaching it either plug the tubing or replace the bag with a clean one.
• Drain all of the urine and rinse with warm water. Fill the bag with 1 part white vinegar and 3 parts water. Allow it to sit for one-half hour, drain, and rinse.
• In order to prevent bacterial growth, let the bag air dry before storing.

Suprapubic Tube (SPT) Care

In order to make sure your device functions effectively, follow these steps and procedures.

• Do not shower with the drainage bag hooked to the catheter. Unhook the bag, plug the catheter, making sure it is properly sealed.
• After completing your shower, reattach the drainage bag. After removing the plug, clean it and store it in a clean bag or container so it’s ready to be used when you need it.
• After cleaning your skin on a daily basis, apply antibiotic ointment.
• If there’s no drainage around the site, then you do not need to apply a gauze pad.
• However, continue to clean the area, gently washing it with warm water.
• Always wash your hands anytime that you disconnect or reconnect the tubing or bag.

Consulting Your Doctor

There are various times when you should consult your doctor regarding your suprapubic catheter. These include:

• When you see redness, blisters or swelling in the area.
• If your skin becomes warm to the touch
• When there is pus draining from the insertion region.
• Any increase in blood or fluid drainage.
• If you notice clots in the urine that don’t go away after increasing your intake of fluids.
• Urine is not properly draining, there’s a major decrease in draining, or no urine drains for an hour.
• Chills and/or a fever of 101 degrees F. or higher.
• You experience nausea or vomiting.
• You have severe pain in the area of the suprapubic Foley catheter or SPT.
• The suprapubic tube becomes dislodged or compromised in another way.

Consult with Your Doctor

If you have a suprapubic catheter and have any questions or concerns, make sure that you contact your doctor as soon as possible. If you notice any signs of infection, experience problems with eliminating urine, or the device malfunctions, it is important that you get help to remedy the problem.